Atrial and ventricular arrhythmia predictors with electrocardiographic parameters in myocardial infarction with non-obstructive coronary artery disease (MINOCA)

Background: The clinical importance and recognition of myocardial infarction with non-obstructive coronary artery disease (MINOCA) is increasing. Nevertheless, no studies are investigating the risk of atrial fibrillation and ventricular arrhythmia in MINOCA patients. This study aimed to determine the risk of arrhythmia with electrocardiographic predictors in MINOCA patients. Methods: In this study, patients diagnosed with MINOCA and stable out-patients without significant lesions in their coronary arteries were compared. Morphology-voltage-P- wave duration electrocardiography (MPV ECG) score was used to determine atrial arrhythmia risk. QT interval and QT dispersion T-peak-T-end time and T-peak-T-end/QT interval were used to determine ventricular arrhythmia risk. Results: A total of 155 patients were included in our study. Seventy-seven of these patients were in the MINOCA group. There was no statistically significant difference between the two groups in MPV ECG score (1.95 +/- 1.03 vs 1.68 +/- 1.14, p = 0.128). P-wave voltage, P-wave morphology and P-wave duration, which are components of the MPV ECG score, were not statistically significantly different. The QRS complex duration (90.21 +/- 14.87 vs 82.99 +/- 21.59 ms, p = 0.017), ST interval (271.95 +/- 45.91 vs 302.31 +/- 38.40 ms, p < 0.001), corrected QT interval (438.17 +/- 43.80 vs 421.41 +/- 28.39, p = 0.005) and QT dispersion (60.75 +/- 22.77 vs 34.19 +/- 12.95, p < 0.001) were statistically significantly higher in the MINOCA group. The T-peak-T-end (89.53 +/- 32.16 vs 65.22 +/- 18.11, p < 0.001), T-peak-T-end/QT interval (0.2306 +/- 0.0813 vs 0.1676 +/- 0.0470, p < 0.001) and T-peak-T-end/corrected QT interval (0.2043 +/- 0.6997 vs 0.1551 +/- 0.4310, p < 0.001) ratios were also significantly higher in patients with MINOCA. Conclusion: In the MINOCA patients, there was no increase in the risk of atrial fibrillation based on ECG predictors. However, it was shown that there could be a significant increase in the risk of ventricular arrhythmia. We believe this study could be helpful for specific recommendations concerning duration of hospitalisation and follow up in MINOCA patients.

Automated summary

The risk of atrial fibrillation is not increased in patients with myocardial infarction with non-obstructive coronary artery disease (MINOCA), but there may be a significant increase in the risk of ventricular arrhythmia.